GI Flashcards

0
Q
  • intermittent watery diarrhea, abdominal distension, anorexia, afebrile
  • h/o drinking bad water on camping trip or attending daycare
  • Dx: ELISA
  • Tx: metronidazole
A

Girardia Lamlia

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1
Q
  • absence of air in the RLQ

- finding suggestive of appendicitis

A

Sentinel loop

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2
Q
  • renal failure
  • thrombocytopenia
  • hemolytic anemia
A

HUS

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3
Q
  • green malodorous stools 2d after a picnic

- osteomyelitis in a SickleCell pt

A

Salmonella

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4
Q
  • fever, HA, abd pain, muscle aches, and Rose spots

- Tx: CTX & Cefotaxime

A

Typhoid fever

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5
Q
  • onset of illness several days after ingestion
  • watery diarrhea & fever –> bloody diarrhea
  • bandemia in absence of incr WBC
  • seizures
  • Tx: Bactrim
A

Shigella (shake-ella)

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6
Q

-produces vasoactive intestinal peptides that can cause diarrhea

A

Neuroblastoma

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7
Q
  • due to fruit juices and excessive water intake
  • MC cause of chronic diarrhea up to age 3
  • formed stool in am becoming progressively looser
  • growth and development are normal
A

Toddler’s Diarrhea

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8
Q

-PLE–>hypoproteinemia, steatorrhea, hypogammaglobulinemia, lymphedema, and lymphopenia

A

Intestinal lymphangectasia

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9
Q
  • non bilious emesis in a neonate
  • manifests within the first 6 months
  • h/o polyhydramnios & LBW
  • Dx: US
  • Tx: surgical
  • radiolucent filling defect in the pre pyloric region
A

antral web

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10
Q
  • MC in males than females
  • progressive non-bilious vomiting
  • MC 1 month after birth (up to 5 mos)
  • Dx: US showing hypertrophied pylorus
  • Tx: surgical
  • hypochloremic metabolic acidosis
A

Pyloric stenosis

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11
Q
  • bilious vomiting the first day of life
  • icteric (diminished enterohepatic circulation)
  • double bubble sign
A

Duodenal atresia

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12
Q

-bilious vomiting, abdominal pain, distension, passing blood via rectum

A

Malrotation

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13
Q
  • infant with bilious vomiting, R sided abd distension

- Xray: gastric and duodenal dilatation, decr intestinal air & corkscrew appearance of the duodenum

A

Volvulus

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14
Q

-dystonic movements of the head and neck along with GER

A

Sandifer syndrome

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15
Q
  • early schoolage child with episodes of vomiting separated by asymptomatic periods
  • emotional overtones, at risk for migraines & IBS
A

Cyclic vomiting

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16
Q
  • frequent regurgitation of ingested food into the mouth, then rechewed & swallowed or spit out
  • appear calm during episodes
  • seen in infants of severely disturbed moms
  • induce vomiting to seek attention
  • Tx: resolving the emotional trigger
A

Rumination

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17
Q

-forceful vomiting, wt loss, dysphagia, FTT

A

Achalasia

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18
Q
  • cyst in the floor of the mouth

- Tx: excision

A

Ranula

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19
Q
  • underdeveloped or absent teeth
  • Dx: skin Bx where no sweat pores are noted
  • X-linked
  • absence of sweat glands
A

Ectodermal hypoplasia

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20
Q

-underdeveloped small teeth

A

Hallermann Streiff Syndrome

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21
Q
  • bright red bloody or tarry stools, hematemesis

- liver disease–>portal HTN

A

Esophageal Varices

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22
Q
  • present with coughing with feeding in the newborn period
  • Xray: feeding tube coiled up in the esophagus
  • MC: upper esophageal pouch
  • copious oral secretions, polyhydramnios, coughing and cyanosis with feeding, inability to pass an NG
  • Tx: NPO & drain the blind pouch
A

TE fistula

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23
Q
  • gastrin secreting tumor
  • Sx: related to PUD
  • Dx: fasting gastrin levels
A

Zollinger Ellison Syndrome

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24
- bulky, pale, frothy, and foul smelling stools - proximal muscle wasting, abd dist - gluten sensitive enteropathy - Dx: Bx, antigliadin or anti endomysial Ab
Celiac Disease
25
- worse diarrhea in the am - emotional component - high fiber diet & attn to emotional factors
Irritable Bowel Syndrome
26
- associated with small bowel resection, parasites, or IBD | - w/u: CBC
B12 deficiency and pernicious anemia
27
-malabsorption, hyponatremia, rectal prolapse, meconium plug, fat soluble vitamin deficiency
GI manifestations of CF
28
- extra teeth, polyps in the large and small intestine (pre-malignant), osteomas - Autosomal dominant - Tx: surgical
Gardner Syndrome
29
- mucosal pigmentation of lips and gums + polyps | - Tx: polypectomy
Peutz-Jeghers Syndrome
30
- teen with crampy lower abdominal pain w/wo bloody stools - fever, hypoalbuminemia, anemia - Ashkenazi Jews are at risk - associate with HLA B27 and ankylosing spondylitis - Tx: 5-ASA, steroids, MTX, cyclosporine - arthritis, mucocutaneous lesions, liver disease
Ulcerative Colitis
31
- wt loss, incr ESR - skip lesions, cobblestoning on EGD, transmural lesions, non-caseating granulomas - pyoderma gangrenosum, erythema nodosum, ankylosing spondylitis, arthritis, uveitis, liver disease, renal stones - Tx: steroids, 5-ASA - aphthous ulcers, perianal fistulas
Crohn Disease
32
- sudden onset severe intermittent colicky abd pain with asymptomatic episodes - drawing up legs and vomiting - may be relieved with passage of stool - bloody stool & sausage like mass - Tx: air enema
Intussusception
33
- delayed passage of meconium as newborn - constipation or intermittent loose stools - Dx: rectal Bx - Tx: surgical excision of aganglionic segment, colostomy & end to end anastamosis
Hirschprung Disease
34
-test for lower GI bleed to determine if blood is mom's or baby's
Apt test
35
-MC cause of lower GI bleeding in children 1-2 years of age
Anal fissure
36
- bloody diarrhea in a child from an Indian reservation or other rural areas in the South, Central, and SW US - Dx: serology - Tx: Flagyl
Entamoeba hiistolytica
37
- presents at age 2 - 2 types of tissue (gastric and intestinal) - 2 feet from ileocecal valve - 2 inches in length - 2% of the population - painless rectal bleeding - Tx: surgical
Meckels Diverticulum
38
- incr direct bili, pale stools, hepatomegaly - Causes: liver/parenchymal disease or anatomical/obstructive disease - Dx: HIDA scan - MC in newborn-->TPN
Cholestatic jaundice
39
- incr direct bili over 1 mo age - Dx: US-->HIDA-->Bx - Tx: Kasai before 2 mos age
Biliary Atresia
40
- intermittent incr serum bili w/ illness/stress - simliar Hx in family members - glucuronyl transferase deficiency
Gilbert Syndrome
41
- recent URI in which ASA was given | - encephalopathy, coma, incr LFTs, and ammonia
Reye Syndrome
42
- hepatitis, RTA, AMS - KF rings - Tx: Penicillamine-->aplastic anemia - result of excess copper
Wilson Disease
43
- mid epigastric pain radiating to the back, rebound, and decr BS - Dx: abd US (most specific), lipase >amylase
Pancreatitis
44
-jaundice, fever, palpable mass RUQ Risks: hemolytic dz, TPN, sm intestine dz, obesity, pregnancy -Dx: abd US -Tx: surgical
Cholecystitis
45
- fecal oral transmission - household contacts and daycare centers - flu-like symptoms, incr LFTs, recent travel - Dx: serum IgM-->acute disease
Hepatitis A
46
- either acute HBV infection or chronic | - one of the earliest indicators of acute infx
HBsAg
47
-previous HBV infx or positive immune response to immunization
Anti-HBsAg
48
-high rate of infectivity and high rate of viral replication
HBeAg
49
-indicates recent HBV infx (up to 6 mos after infx)
HBcAg IgM
50
- liver dz and cirrhosis - incr incidence of hepatocellular carcinoma - transmitted through blood and sex
Hepatitis C
51
- requires the presence of HBsAg to provide its outercoat | - chronic hepatitis or cirrhosis
Hepatitis D
52
- transmitted via fecal oral route - MC in Asia, Africa, and Mexico - exposure to contaminated water
Hepatitis E
53
- low pH - high pCO2 - hypoventilation - CNS dysfunction - narcotics
Respiratory acidosis
54
- high pH - low pCO2 - hyperventilation "blow off CO2" - triggered by hypoxia or high altitude - compensation thru incr bicarb resorption in kidneys
Respiratory alkalosis
55
- high pH - high bicarb - compensation by hypoventilation and holding onto CO2
metabolic alkalosis
56
- low pH - low bicarb - compensate with hyperventilation to decr CO2
Metabolic acidosis
57
- hypochloremic metabolic acidosis (incr pH) - loss of HCl - increased bicarb resorption in kidneys - low urine Cl (kidneys retain) - low Na - low or nl K - maybe hyperbili
Pyloric stenosis
58
``` Ureterostomy Small bowel fistula Extra chloride Diarrhea Carbonic anhydrase inhibitors Adrenal insufficiency Renal tubular acidosis Pancreatic fistula ```
normal anion gap
59
- distal tubule does not excrete H+ - urine: high pH >5.5 - incr calciuria - normal bicarb (prox tubule ok) - mimicked by spironolactone)
Distal (Type 1) RTA
60
- proximal tubule unable to absorb bicarb - excessive bicarb in urine - distal tubule still releases H+ - urine pH <5.5 - mimicked by carbonic anhydrase inhibitiors
Proximal (Type 2) RTA
61
- aldosterone resistance or aldosterone deficiency - urine pH <5.5 - hyperkalemia
Type 4 RTA
62
``` Methanol Uremia DKA Paraldehyde Ingestion/INH Lactic acid Ethanol/Ethylene glycol Salicylates ```
Elevated anion gap metabolic acidosis
63
- healthy appearing infant at birth - lethargy, poor feeding, seizures - low WBC & plts - elevated serum ammonia - hypertension - elevated anion gap
Organic acidemia (proprionic or methylmalonic acidemia)
64
- hyperammonemia | - NO metabolic acidosis
Urea Cycle Defects
65
- incr serum Osm - dilute urine - Tx: drink H20, DDAVP if central - -incr Na, Cl, BUN, decr SpGr
Diabetes Insipidus
66
- dilute urine - hypernatremic dehydration - X-linked- found in males - fails to respond to DDAVP
Nephrogenic DI
67
- hypernatremia | - low urine Na (kidneys hold onto Na)
GI losses-->hypoNa
68
- hyponatremia - fluid retention, decr UOP - incr urine Osm and incr urine Na - Tx: fluid restriction, Demeclocycline (inhibits ADH secretion from kidneys) - decr Na, Cl, BUN, incr SpGr
SIADH
69
- hyponatremia - no volume depletion - seizures from cerebral edema - incr urine Na concentration (total body Na is nl)
Water intoxication
70
- low serum Na - incr TG or plasma prot, or gluc (Nephrotic Syndrome) - edema - incr total body Na *** - nl Cl, BUN, SpGr
Pseudohyponatremia
71
- weakness and paralysis - constipation and ileus - GI or renal losses - EKG: flattened T waves or U wave, ST depression, PVCs
Hypokalemia
72
- Causes: renal failure, cell breakdown, excess intake, redistribution - EKG: peaked T waves, absence of p waves, widened QRS - Treatment: insulin and glucose, Sodium bicarb, Albuterol, Lasix, oral polystyrene, ***CaGluc
Hyperkalemia
73
UNa SCr/ UCr SNa <1.5 low urine Na loss (pre renal azotemia) >2.5 high urine Na loss
FeNa
74
-GI losses, given tea or water -seizures -poor skin turgor -more symptomatic on presentation -Tx: :3% saline (desired Na - measured Na) x wt x 0.6 = A A + maintenance (3mEq/kg/day = replacement -pontine damage -decr Na, Cl, incr BUN, SpGr
Hyponatremic dehydration
75
- Cause: Na gain or water loss --> incr Na in ECF - improper feeding - Sx: doughy skin, high pitched cry, irritable, lethargy, seizures (remember Noah Lynch) - Tx: assume 10% dehydration - clinical picture is deceptively good - risk for cerebral edema with correction - incr Na, Cl, BUN, SpGr
Hypernatremic dehydration
76
- decr Na, incr Cr - incr UOP - Incr UNa, incr UOsm - Tx: replace fluid and GI losses
Cerebral salt wasting